Kornimate/medical-research-clean huggingface dataset:
intraperitoneal atomization of levobupivacaine during gynaecological laparoscopic procedures ; impact on pain, opioid use and length of recovery room stay (ipla).

Conditions: Pain, Postoperative

Summary: in this study, we will compare 3 treatments. the first group of patients will receive the standard treatment (paracetamol, diclofenac and an opioid if necessary) with infiltration of the portal sites with the local anesthetic ( 0.5% levobupivacaine) . the second group of patients will receive the standard of care, with infiltration of the portal sites with the local anesthetic ( 0.5% levobupivacaine) and additional injection of the local anesthetic ( 0.5% levobupivacaine, non -diluted) in the peritoneal cavity via a trocar both at the beginning and the end of the surgery . the third group of patients will receive the standard of care, with infiltration of the portal sites with the local anesthetic ( 0.5% levobupivacaine) and additional intraperitoneal atomization of the local anesthetic. we will use non-diluted 0.5% levobupivacaine delivered directly onto the target sites both at the beginning and the end of surgery. the drug will be delivered using optispray® surgical spray device, an inexpensive delivery system that will direct a fine mist of drug directly to the areas of the peritoneal cavity that are theoretically the cause of post-op pain (diaphragms, peritoneal abdominal surface, surgical dissection site). our primary goal is to assess the efficacy of intraperitoneal atomization of levobupivacaine in reducing postoperative pain and of opioid requirements in patients undergoing gynecological laparoscopic procedures in one-day surgery.


Eligibility criteria:
inclusion criteria: * patients who are planned for gynaecological laparoscopic interventions on an ambulatory basis. exclusion criteria: * less than 18 year old. * weight less than 50 kg and more than 80 kg. * pregnant. * prisoners; * allergic to topical anesthetics (amides specifically). * allergic to opioids as a class. * currently or within the last 30 days been prescribed an opiate medication. * chronic pain syndrome.

Keywords: laparoscopic pain
characterization of bile acid pathway in obesity

Conditions: Obesity

Summary: it is unknown whether the bile acid pathway is altered in obesity. this study is designed to compare obesity and health to determine if the bile acid pathway differs depending on health state.

this is a single center study involving diet intervention, including healthy obese and healthy normal weight participants. participants will maintain their normal diet for 1 week, eat a high fat and high calorie diet for 1 week, return to their normal diet for 1 week, and eat a low fat and low calorie diet for 1 week, to study the effect of diet on the bile acid pathway in normal weight and obesity. during their first normal diet week, the high calorie week, and the low calorie week, blood samples will be collected at defined times to measure cholesterol, glycemia, fibroblast growth factor 19 (fgf-19), bile acid (ba), c4, and incretins (glp-1 (glucagon-like peptide-1), peptide tyrosine tyrosine (pyy 3-36)) fasting levels and responses to the meal. stool samples will be collected for 48 hour ba excretion.

Eligibility criteria:
normal weight inclusion criteria: * women of childbearing potential will have negative pregnancy tests within 48 hours of enrollment * bmi: 18.5-25 kg/m2 obese inclusion criteria: * women of childbearing potential will have negative pregnancy tests within 48 hours of enrollment * bmi: ≥ 30 kg/m2 exclusion criteria for both normal weight and obese participants: * history of abdominal surgery including cholecystectomy and other than appendectomy, caesarian section or tubal ligation. * positive history of chronic gastrointestinal diseases, or systemic disease that could affect gastrointestinal motility, or use of medications that may alter gastrointestinal motility, appetite or absorption, e.g., orlistat, phentermine. * significant untreated psychiatric dysfunction based upon screening with the hospital anxiety and depression inventory (had), a self-administered alcoholism screening test (audit-c) and the questionnaire on eating and weight patterns (binge eating disorders and bulimia). if such a dysfunction is identified by a had score \>11 or difficulties with substance or eating disorders, the participant will be excluded and given a referral letter to his/her primary care doctor for further appraisal and follow-up. the audit-c is a 3-item alcohol screening questionnaire that reliably identifies participants who are hazardous alcohol drinkers or have active alcohol use disorders. in men, a score of 4 or more is above the recommended limits will be reviewed by study personnel. in women, a score of 3 or more is above the recommended limits will be reviewed by study personnel. however when the points are above recommended limits, the provider will review the patient's alcohol intake over the past few months to confirm accuracy and determine study eligibility.. * intake of medication, whether prescribed or over the counter (except multivitamins), within 7 days of the study. exceptions are birth control pill, estrogen replacement therapy, and thyroxin replacement therapy.
oct guided punctal stenosis management

Conditions: Epiphora Due to Insufficient Drainage

Summary: this is a clinical trial study that was conducted on patients with punctal stenosis.we studied the diameter of stenosed puncta before and after treatment with preserved free steroid eye drops using as-oct.

the study was conducted on 40 eyes of 24 patients have acquired inflammatory punctal stenosis and 20 eyes of 10 patients of normal asymptomatic subjects as control group. we studied the external punctal diameter, visibility of the internal punctum and punctal depth before treatment using as-oct, and then patients were re-evaluated after one month of treatment with preservative free methylprednisolone 5% eye drops.

Eligibility criteria:
inclusion criteria: * patients have acquired inflammatory punctum stenosis complaining of epiphora of different etiologies. exclusion criteria: * previous lacrimal surgery. * lid margin malposition such as ectropion, entropion or lid retraction. * medial lid masses obscuring punctum. * history of ocular trauma involving lid margin or punctum.
effect of lactobacillus on the microbiome of household contacts exposed to covid-19

Conditions: Microbiome

Summary: the purpose of this study is to evaluate the effect of the probiotic lactobacillus rhamnosus gg (lgg) and the effect of covid-19 on the microbiome (the microorganisms that live in and on the human body) in exposed household contacts of covid-19. this is a randomized, double-blind, placebo-controlled study, meaning subjects will be randomly assigned to receive lgg or a placebo (an inactive substance given in the same form as the active substance) and will not know which product they are receiving. subjects will participate in the study for around 60 days. all subjects must refrain from taking any other probiotics while on study. all subjects must have access to e-mail and the internet to complete study questionnaires. participation in this study entails taking lgg/placebo for 28 days, responding to questionnaires, and providing stool and nasal swab samples.


Eligibility criteria:
inclusion criteria: * age \>=1 year (as children \<1 year may not be able to take oral probiotics) * household contact of someone diagnosed with covid-19 * willingness to stop taking other probiotics or to not take any other probiotic while on lgg/placebo (taking a probiotic at the time of screening will not be considered a reason for exclusion. however, subjects will be asked to stop taking their probiotic if they enroll on the study). * access to e-mail/internet to complete electronic consent via redcap exclusion criteria: * symptoms of covid-19 at enrollment, including: * fever * respiratory symptoms * gi symptoms * anosmia * ageusia -\>7 days since original patient associated with household contact was diagnosed with covid-19 * taking hydroxychloroquine or remdesivir for any reason (as this would have the potential to decrease the expected rate of covid-19 in this population and affect our power and sample size calculations) * enrolled in a covid-19 prophylaxis study (as this would have the potential to decrease the expected rate of covid-19 in this population and affect our power and sample size calculations) * any medical condition that would prevent taking oral probiotics or increase risks associated with probiotics including but not limited to: * inability to swallow/aspiration risk and no other methods of delivery (e.g., no g/j tube) * increased infection risk due to immunosuppression due to: * chronic immunosuppressive medication * prior organ or hematopoietic stem cell transplant * known neutropenia (anc \<500 cells/ul) * hiv and cd4 \<200 cells/ul * increased infection risk due to endovascular due to: * rheumatic heart disease * congenital heart defect, * mechanical heart valves * endocarditis * endovascular grafts * permanent endovascular devices such as permanent (not short-term) hemodialysis catheters, pacemakers, or defibrillators * increased infection risk due to mucosal gastrointestinal due to: * gastroesophageal or intestinal injury, including active bleeding

Keywords: covid-19 lactobacillus rhmanosus gg
cardiometabolic status in childhood acute lymphoblastic leukemia

Conditions: Acute Lymphoblastic Leukemia

Summary: this is a prospective cohort study assessing measures of cardiometabolic status, body composition, ir and gh response to stimulation after therapy in children (age 7-21 years) treated for all. patients and sibling controls will be recruited from the pediatric hematology-oncology clinic at the university of minnesota amplatz children's hospital.

this is a prospective cohort study with two groups: survivors of acute lymphoblastic leukemia (all) who have recently completed therapy (cases) and healthy siblings (controls) frequency matched by age and sex. subjects in each group will have two visits. for cases, the first visit will be approximately 6 months after completion of treatment for all; for their siblings, the first visit occur at approximately the same time. for both cases and controls, the second visit will be 2 to 2.5 years after the first visit.

Eligibility criteria:
inclusion criteria: * patients * age 7 years to less than or equal to 21 years at time of study enrollment. * acute lymphoblastic leukemia (all) as first cancer diagnosis and in first complete remission. any subtype is eligible. * study enrollment must take place at/after six months of completion of all chemotherapy. * patients must have a performance status corresponding to eastern cooperative oncology group (ecog) scores of 0, 1, or 2. use karnofsky for patients \> 16 years of age and lansky for patients ≤ 16 years of age. * any prior all therapy is allowable. * siblings * age 7 years to less than or equal to 21 years at time of study enrollment. * sibling of all patient. exclusion criteria: * patients * diagnosis of diabetes mellitus prior to all diagnosis or at time of study enrollment. * current pregnancy * prior hematopoietic cell transplant. * receiving growth hormone replacement or corticosteroids at the time of enrollment. * siblings * previously diagnosed with malignancy. * diagnosis of diabetes mellitus. * current pregnancy * receiving growth hormone replacement or corticosteroids at the time of enrollment.
blood flow restriction training in pre-frail and frail older adults

Conditions: Frailty

Summary: frailty is most often defined as a syndrome of physiological decline in late life, characterized by marked vulnerability to adverse health outcomes. intervention such as exercise, especially resistance exercise, has proven to be effective to improve frail condition in the elderly in the previous literature. however, blood flow restriction (bfr) training, a new resistance exercise training method, need merely lower resistance power and shorter training duration compared with traditional resistance exercise. previous researches also demonstrated bfr can increase muscle mass and muscle strength in the healthy elderly but the effect of bfr training on the pre-frail or frail elderly is unknown. the aim of this study will test the effect of bfr training on muscle strength and functional performance in pre-frail or frail elderly. participants aged over 60 years old with clinical frailty score between 3 to 5 will be recruited. participants will be assigned to two groups using randomized block design with bfr training and control group. structured questionnaire and physical function measurement will be used to assess the pre-intervention condition and outcome of different interventions. the participants will be assessed before training (pre-test), 3 weeks after training, and 6 weeks after training (post-test), and followed up at one and three months after training. physical function measurement will include hand grip, muscle mass over trunk and extremity, muscle strength of lower extremity, gait speed and timed up and go test. two-way repeated measures analysis of variance will be used to test the pre-test, 3-week, post-test and follow-ups difference between the two groups.


Eligibility criteria:
inclusion criteria: * aged over 60 years old * fried frailty index fulfill 1-2 criteria * able to walk 6 meters independently * able to understand and follow ≥ 3 instructions exclusion criteria: * severe hypertension (\>180/110mmhg) * peripheral neuropathy * history of deep-vein thrombosis (dvt) * cardiovascular diseases (i.e. heart failure nyha classification iii or iv, myocardial infarction, pulmonary hypertension, coronary artery stenosis) * neuromuscular diseases (i.e. stroke, parkinsons' disease) * history of resisted exercise training program within the last 6 months before screening

Keywords: blood flow restriction resistance exercise frailty
turkish version of nijmegen questionnaire

Conditions: Hyperventilation Syndrome

Summary: the study aims to provide turkish version of nijmegen questionnaire for the evaluation of respiratory dysfunction in asthmatic subjects. the incidence of hyperventilation syndrome in asthmatic patients can be determined with the results of the study.

nijmegen questionnaire allows to assess and identify respiratory symptoms and dysfunction, and to assess unexplained respiratory symptoms and symptoms of hyperventilation syndrome. determining whether turkish version of nijmegen questionnaire is a valid and reliable tool in asthmatic individuals will guide researchers for further studies on identifying appropriate treatment approaches for the patient and developing different treatment strategies. hyperventilation syndrome is a recognized form of respiratory dysfunction associated with biochemical factors. hyperventilation syndrome is defined as breathing above the body's metabolic requirements. this results in decreased carbon dioxide pressure in the arterial blood, respiratory alkalosis, and increased symptoms. complex symptoms such as shortness of breath, chest tightness, paresthesia, anxiety, and dizziness may occur. there is no laboratory test which is the gold standard in the diagnosis of hyperventilation syndrome. if it is concluded that the turkish version of the nijmegen questionnaire is a valid and reliable test in individuals with asthma, a new tool will be introduced to the literature for the evaluation of pulmonary dysfunction in asthmatic individuals.

Eligibility criteria:
inclusion criteria: * having mild to moderate clinically stable asthmatic patients * being able to cooperate * being 18 years old or older exclusion criteria: * having severe orthopedic, neurological, cardiovascular disorders or cognitive problems * unable to cooperte
characteristics of gut microbiota in patients with colon cancer of different traditional chinese medicine syndromes

Conditions: Colorectal Neoplasms

Summary: guided by the idea of combining disease differentiation with syndrome differentiation in traditional chinese medicine, this study used the form of questionnaire to summarize the changes of tcm syndromes, tcm constitution types in colorectal cancer patients before and after surgery. the next-generation sequencing technology was used to explore the changes and differences of intestinal microorganisms before and after surgery. the correlation between changes of tcm syndromes, tcm constitution types, intestinal microbial evolution and tumor biological characteristics in colorectal cancer patients before and after surgery was analyzed. to explore the rationality of tcm in the prevention and treatment of colorectal cancer recurrence and metastasis in order to guide the individualized treatment and dietary regulation of tcm.


Eligibility criteria:
inclusion criteria: 1. preoperative abdominal ct, colonoscopy and pathological examination were diagnosed as colorectal malignant tumor patients; 2. having surgical indications; 3. patients who were not treated with antibiotics or microbiological agents one week before surgery; 4. patients who had not received radiotherapy and chemotherapy before surgery; 5. patients or their legal representatives informed and agreed to participate in this clinical trial and signed a written informed consent; exclusion criteria: 1. have other cancer history; 2. patients who have received invasive treatment within the past three months; 3. inflammatory bowel disease such as ulcerative colitis or crohn's disease; 4. combined with intestinal obstruction or intestinal perforation for emergency surgery; 5. psychiatric history, can not join and standardize the completion of clinical investigators; 6. pregnant or nursing women; 7. patients treated with antibiotics or microbiological agents one week before surgery; 8. people have incomplete data;

Keywords: gut microbiota 16s rdna sequebcing tcm sydromes tcm constitution types
physiological strain in young adults during a simulated heat wave

Conditions: Heat Stress; Physiological Stress

Summary: the likelihood of exposure to overheated indoor environments is increasing as climate change is exacerbating the frequency and severity of hot weather and extreme heat events. prolonged exposure to excessive heat stress can result in a deterioration in physiological function leading to a myriad of pathophysiological conditions (e.g., heat exhaustion, acute kidney injury, adverse cardiovascular events, heat stroke) that if left untreated can lead to death. while the relationship between extreme heat events and human health has been assessed in relation to outdoor exposure to high heat conditions, relatively little is known about the effects of daylong exposures to indoor overheating on the body's physiology. in this study, investigators will examine the change in physiological responses (i.e., thermal, cardiovascular) in young (18-35 years) adults exposed to successive days and nights of high indoor temperatures typical of conditions recording in dwellings without air conditioning during the 2021 western heat dome. specifically, study participants will be housed in a large environmental chamber (outfitted with bed, work space, sitting area, kitchen and bathroom) for three successive days (three days and two nights) while exposed to indoor overheating where daytime temperatures will be maintained at 36°c (45% relative humidity; note: 36°c, temperatures experienced in homes without air-conditioning) for a 10-hour daytime exposure period (daytime: defined as the time period from 9:00 to 19:00). for the nighttime exposure period (nighttime: defined as the time period from 19:00 to 9:00), participants will be exposed to nighttime temperatures fixed at 31°c (45% relative humidity; note: reductions in indoor temperatures during the nighttime in large urban centers range between 4-6°c). participants will be permitted to move freely throughout the day in the chamber, but will be restricted from performing any physical activity except for the completion of a battery of tests (cardiovascular, cognitive and posture assessments performed prior to (as performed between 7:00 and 9:00) and the end (as performed between 17:00 and 19:00) of the daytime exposure). during the nighttime period, participants will be permitted to move freely until they decide to go to bed.


Eligibility criteria:
inclusion criteria: * non-smoking. * english or french speaking. * ability to provide informed consent. exclusion criteria: * chronic health conditions. * endurance trained * regular exposure to heat (e.g., hot baths, sauna, regular exercise in the heat, recent vacation to area with high temperature).

Keywords: heat wave indoor temperatures thermoregulation heat strain young adults cardiovascular strain sleep fatigue
pneumonia in tetanus study

Conditions: Tetanus

Summary: this is a randomised controlled trial of the incidence of nosocomial pneumonia in patients with severe tetanus admitted to the intensive care ward nursed in a supine or semi-recumbent position.

background: hospital-acquired pneumonia remains a common and important cause of morbidity and mortality in patients with severe tetanus who require a tracheostomy whether or not they are mechanically ventilated. we propose to investigate if the incidence of hospital-acquired pneumonia can be reduced by nursing tetanus patients semi-recumbent at 30o rather than supine as is the current practice. the aim of this study will be to assess the frequency of clinically suspected and microbiologically confirmed hospital acquired pneumonia in patients nursed in a semi-recumbent or supine body position. a secondary end-point will be the mortality in each group. patients at risk of developing hospital acquired pneumonia (in hospital without developing pneumonia for more than two days) will be evaluated

Eligibility criteria:
inclusion criteria: 1. consecutive patients will be entered into the study as they are admitted to the intensive care ward with a clinical diagnosis of tetanus. 2. informed consent will be obtained from the patient or next-of-kin before randomisation. 3. an envelope for the next study number will be opened in which patients will be randomly allocated to either semi-recumbent (300) or supine (00) body position. the randomisation will be created by a computer generated list. 4. all health care personnel will be instructed not to change the position, unless for medical requirements. 5. the correctness of the position will be checked twice daily. 6. surveillance for clinical detection of pneumonia or other infection will be done daily. if infection is suspected relevant microbiological samples will be taken. 7. the study period will end 72 hours after the patient has left the intensive care ward, or if there is a permanent change in body position for more than 1 hour or death. exclusion criteria: 1. recent abdominal surgery (\<7 days) 2. shock refractory to vasoactive drugs or volume therapy 3. recent intensive care (\<30 days) 4. neonates 5. pneumonia at the time of admission to intensive care.